National health system steps in Turkey: Concerns of family physician residents in turkey regarding the proposed national family physician system
School of Nursing, Gazi University, Ankara, Turkey. The health care manager
07/2006; 25(3):254-62. DOI: 10.1097/00126450-200607000-00010
Many countries are currently struggling with the public desire for improved health care and provision of basic services on the one hand, and the rising costs of health care on the other. Turkey is acutely experiencing this problem because of its relatively advanced level of economic development and its relatively low level of health status compared to Organization for Economic Cooperation and Development and European Union countries. Since 1990, there has been vigorous debate in the Turkish society regarding the best way to improve public health through improved primary health care. The current government is pursuing a proposal that has been mentioned before, but in a more serious effort than has been previously made. This is an approach to primary care based on systems such as those in the United Kingdom and in Germany, and the basic components are family physicians who have a particular list of patients whom they provide care for. Financing of the system is to be provided with a new general health insurance scheme. In this study, 38 family practice residents at the 3 major training hospitals for this specialty completed an investigator-designed questionnaire for the purpose of characterizing their concerns regarding this proposed system of primary health care delivery. The participants' responses indicated that the new system, which is known as the Family Physician System, will contribute importantly toward raising the overall level of health in Turkey. Specific expected benefits include closer patient-physician relationships, increased job satisfaction on the part of family physicians, and an overall increase in income for the physicians working in the system.
Available from: Osman Hayran
- "The second planned phase is a 1-year modular training programme. Within this plan, the physicians who complete their first phase orientation training go onto the second longer term training phase. During this time, and after signing a new contract, physicians begin working as FPs in their offices. "
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Background: In Turkey, general practitioners were authorized to work as family physicians without specialization, within the scope of the
Health Transformation Programme, due to inadequate number of family medicine specialists since 2004. With this new implementation
Family Medicine specialty became a less preferable option for medical students. Aims: The study was to investigate the perspectives
of medical students and understand the issues to choose Family Medicine specialty as a career option. Materials and Methods: This
qualitative study was performed with 48 fi nal year medical students using a convenience sample from two medical universities. Results:
Three main categories emerged from the data viewing Family Medicine ‘as a specialty’, ‘as an employment’, and fi nally ‘as a system’.
Very few students stated that Family Medicine would be their choice for specialty. Conclusions: Family Medicine does not seem to be
an attractive option in career planning by medical students. Several factors that may constrain students from choosing Family Medicine
include: not perceiving Family Medicine as a fi eld of expertise, and the adverse conditions at work which may originate from duality in
Available from: Fusun Yaris
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ABSTRACT: To determine the factors affecting medical students' choice of the specialty of family medicine.
The study was conducted in the period from 2004-2006 and comprised 770 first-year medical students from Ondokuz Mayis, Karadeniz Technical, Kocaeli, and Adnan Menderes Universities, Turkey. The questionnaire included questions on demographic data and 6 "yes/no" or open-ended questions on students' career aspirations and the specialty of family medicine.
The response rate was 93.1% (n=717, 54.7% male). Nearly all students (n=714, 99.6%) showed an intention to specialize after receiving the medical doctor degree. A total of 187 students (26.2%) showed an intention to work in primary care without specialization "for a temporary period" to "gain some experience." Family medicine was the least preferred specialty (n=7, 0.9%). The most important reasons for the choice of specialty were "better financial opportunities" and "prestige" (n=219, 30.5%), followed by "personal development" (n=149, 20.8%), "more benefits for the patient" (n=128, 17.9%), and "wish to work in an urban area" (n=32, 4.5%). The most preferred specialties were cardiology (n=179, 25.0%), pediatrics (n=121, 16.9%), ophthalmology (n=47, 6.6%), physical therapy and rehabilitation (n=34, 4.7%), and obstetrics and gynecology (n=32, 4.5%).
Prestige, money, and personal development are important factors in career decision-making among medical students in Turkey. This should be taken into consideration when conducting reforms at the primary level.
Available from: Mustafa Koyuncu
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ABSTRACT: Purpose – The purpose of this paper is to investigate gender differences in work experiences, satisfactions and psychological health among physicians in Turkey. Design/methodology/approach – Data were collected from 237 male and 194 female physicians using an anonymously completed questionnaire. Measures included personal demographic and work situation characteristics, stable individual difference factors (e.g. workaholism components, Type A behavior, optimism), job behaviors (e.g. perfectionism, hours worked), work and extra-work satisfactions, indicators of work engagement, and psychological wellbeing. Findings – There were few differences in personal demographic and work situation characteristics. Female physicians had less professional tenure and worked fewer hours and extra-hours per week. Female and male physicians were similar on stable individual difference factors, job behaviors, work outcomes, extra-work satisfactions and psychological wellbeing, with a few exceptions. Female physicians reported more work-family conflict and more psychosomatic symptoms and tended to be absent more. Research limitations/implications – Data were collected using self-report questionnaires raising the possibility of response set tendencies. It is also not clear to what extent these findings generalize to male and female physicians in other countries. Originality/value – Despite previous studies showing considerable gender differences in the work experiences and wellbeing of female and male physicians in other countries, female and male physicians in Turkey reported generally similar job behaviors, satisfactions, quality of life and emotional wellbeing. This suggests that an emphasis on gender similarities rather than gender differences might be warranted.
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